青海省某三级综合医院碳青霉烯耐药革兰阴性杆菌医院获得性感染的经济负担  

Economic burden of healthcare-associated infection due to carbapenem-resistant gram-negative bacilli in a tertiary general hospital of Qinghai province

作　　者：冶挺 刘佳微 刘迪 赵晓宇[1] 王梅英[1] 刘彦民[2] YE Ting;LIU Jia-wei;LIU Di;ZHAO Xiao-yu;WANG Mei-ying;Liu Yan-min(Qinghai Provincial People'sHospital,Xining,Qinghai 810007,China)

机构地区：[1]青海省人民医院感染管理科,青海西宁810007 [2]青海省人民医院科教处,青海西宁810007

出　　处：《中华医院感染学杂志》2022年第6期925-929,共5页Chinese Journal of Nosocomiology

基　　金：青海省科技厅基金资助项目(2018-SF-114);青海省卫健委指导性课题基金资助项目(2019-wjzdx-35)。

摘　　要：目的 分析青海省某三级综合医院碳青霉烯耐药革兰阴性杆菌(CRO)感染情况及经济负担。方法 回顾性收集2017年1月-12月在青海省人民医院住院患者发生肺炎克雷伯菌、鲍氏不动杆菌、铜绿假单胞菌医院获得性感染的临床资料、住院天数和住院各类费用。根据药敏结果将患者分为耐药组和非耐药组,比较两组患者住院天数和住院费用的差异。结果 521例患者纳入此次研究,其中120例患者为CRO感染(耐药组),401例患者为碳青霉烯敏感细菌感染(非耐药组)。耐药组患者中位住院时长为19 d,中位住院总费用为31 292元;非耐药组患者中位住院时长为15 d,中位住院总费用为22 610元,差异有统计学意义(P<0.05)。分层分析显示,碳青霉烯耐药的肺炎克雷伯菌感染患者中位住院时长为17 d,中位住院总费用为25 227元,非耐药的住院时长为14 d,中位住院总费用为20 326元;耐药组呼吸道和血流感染的中位住院时长分别为19 d和30 d,中位住院总费用为30 315元和30 050元,非耐药菌呼吸道和血流感染住院中位时长分别为15 d和13 d,中位住院总费用为21 562元和24 853元,差异有统计学意义(P<0.05)。结论 住院患者发生CRO医院感染会增加住院时间和住院费用,给患者带来经济负担,应采取有效防控措施以降低CRO医院感染的发生率。OBJECTIVE To explore the prevalence of carbapenem-resistant gram-negative bacilli(CRO) infection and the economic burden in a tertiary general hospital of Qinghai province. METHODS The clinical data, length of hospital stay and costs of hospitalization were retrospectively collected from the patients with Klebsiella pneumoniae, Acinetobacter baumannii and Pseudomonas aeruginosa hospital-acquired infection who were hospitalized in Qinghai Provincial Hospital from Jan 2017 to Dec 2017. The patients were divided into the drug-resistant group and the non drug-resistant group according to the result of drug susceptibility testing. The length of hospital stay and hospitalization cost were compared between the two groups of patients. RESULTS A total of 521 patients were involved in the study, 120 of who had CRO infection( the drug-resistant group), and 40 had carbapenem-sensitive organisms infection( the non drug-resistant group). The median length of hospital stay of the drug-resistant group was 19 days, the median total hospitalization cost was 31 292 yuan;the median length of hospital stay of the non drug-resistant group was 15 days, the median total hospitalization cost was 22 610 yuan, and there were significant differences between the two groups(P<0.05). Stratified analysis showed that the median length of hospital stay of the patients with carbapenem-resistant K.pneumoniae infection was 17 days, the medial total hospitalization cost 25 227 yuan, the length of hospital stay of the non drug-resistant group was 14 day, the median total hospitalization cost 20 326 yuan;the median lengths of hospital stay of the patients with respiratory tract infection and the patients with bloodstream infection were respectively 19 days and 30 days in the drug-resistant group, the median total hospitalization costs were respectively 30 315 yuan and 30 050 yuan;the median lengths of hospital stay of the patients with respiratory tract infection and the patients with bloodstream infection were respectively 15 days and 13 days in the n

关 键 词：碳青霉烯耐药革兰阴性杆菌 医院感染 经济负担 住院天数 青海 

分 类 号：R197.3[医药卫生—卫生事业管理]